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DETAILED CONTENTS

Preface ......................................................................................................................xv

Acknowledgments ...............................................................................................xxi

Chapter 1 Health, Healthcare, and Healthcare Organizations ................................. 1Health and What Determines It ............................................................. 2

Determinants of Health ..................................................................... 3Healthcare and Health Services .............................................................. 7Healthcare Organizations ....................................................................... 9The External Environment of Healthcare Organizations ....................... 10Healthcare Trends and Future Developments ....................................... 12

Stakeholders and Expectations of HCOs ......................................... 16Healthcare Management Jobs and Careers ............................................ 18

Chapter 2 Management ........................................................................................ 29What Is Management? .......................................................................... 31The History and Evolution of Management Theory .............................. 31

Taylor and Scientific Management ................................................... 31Fayol and Administrative Theory ..................................................... 32Mayo and Human Relations ............................................................ 36Gulick, Urwick, and Management Functions .................................. 37Weber and Bureaucratic Theory ....................................................... 38

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Bertalanffy, Boulding, and Open Systems Theory ............................ 39Lewin and Organization Development Theory ................................ 41Woodward and Contingency Theory ............................................... 42Katz and Management Skills ........................................................... 42Meyer and Rowan, DiMaggio and Powell, and Institutional Theory 43Mintzberg and Management Roles .................................................. 43

Do All Managers Manage the Same Way? ............................................. 45

Chapter 3 Planning ............................................................................................... 51What Is Planning? ................................................................................ 52Strategic Planning ................................................................................ 54

Strategic Planning Stage 1: Environmental Assessment .................... 55Strategic Planning Stage 2: Organizational Direction ....................... 60Strategic Planning Stage 3: Strategy Formulation ............................. 63Strategic Planning Stage 4: Transition to Implementation ................ 64

Planning at Lower Levels ...................................................................... 67Project Planning and Project Management ...................................... 68

Data and Information for Planning ...................................................... 71Final Thoughts About Planning ............................................................ 73

Chapter 4 Organizing: Jobs, Positions, and Departments ...................................... 79Organizations ....................................................................................... 81Organizing Work in Healthcare Organizations ..................................... 81Organizing Tasks into Jobs and Positions .............................................. 83Organizing an HCO’s Jobs and Positions into Departments ................. 85Factors That Influence Organizing Work .............................................. 89

External Factors ............................................................................... 89Internal Factors................................................................................ 92

A Few Complications ........................................................................... 93Informal Organization ..................................................................... 93Contract Workers ............................................................................ 95Unionized Workers .......................................................................... 95Medical Jobs with Physicians ........................................................... 96

Chapter 5 Organizing: Organizations ................................................................. 103Organization Structures ...................................................................... 105

Functional Structure ...................................................................... 106Divisional Structure ....................................................................... 108Matrix Structure ............................................................................ 110Horizontal Structure ...................................................................... 113Network Structure ......................................................................... 114

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Hybrid Structures .......................................................................... 117Governing Body ................................................................................. 118Coordination Within and Beyond an HCO ....................................... 119

Coordination Structures and Processes .......................................... 120Complications .................................................................................... 123

Contract Departments ................................................................... 124Physicians and the Organized Medical Staff in a Hospital .............. 124

Chapter 6 Organizing: Groups and Teams .......................................................... 131Groups and Teams .............................................................................. 133

Groups and Teams in Healthcare Organizations ............................ 134Structures of Groups and Teams ......................................................... 135

Purpose ......................................................................................... 135Size ............................................................................................... 136Membership .................................................................................. 137Relation to Organization Structure ................................................ 140Authority ....................................................................................... 140Leader ........................................................................................... 141Culture .......................................................................................... 141

Processes of Groups and Teams ........................................................... 142Developing .................................................................................... 142Leading ......................................................................................... 144Communicating and Interacting.................................................... 145Decision Making ........................................................................... 147Learning ........................................................................................ 148

Effective Groups and Teams ............................................................... 149Effective Virtual Teams .................................................................. 150Guidelines for Effective Meetings .................................................. 150

Chapter 7 Staffing: Obtaining Employees ........................................................... 157Staffing Processes ................................................................................ 159

Workforce Diversity and Inclusion ................................................ 160Centralized, Decentralized, and Outsourced Staffing ..................... 162Laws and Regulations .................................................................... 165

Planning for Staff ............................................................................... 165Designing Jobs and Work ................................................................... 168

Job Analysis ................................................................................... 168Work Rules and Schedules ............................................................. 170

Hiring Staff ........................................................................................ 171Recruiting ..................................................................................... 171Selecting ........................................................................................ 174

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Chapter 8 Staffing: Retaining Employees ............................................................ 185Developing Staff ................................................................................. 187

Orientation of New Staff ............................................................... 187Training Staff ................................................................................. 189Developing Staff ............................................................................ 190

Appraising Performance of Staff.......................................................... 192Appraisal Process and Methods ...................................................... 194When Job Performance Is Deficient ............................................... 197

Compensating Staff ............................................................................ 199How Is Pay Determined? ............................................................... 200How Are Benefits Determined? ..................................................... 203

Protecting Staff ................................................................................... 204Onboarding ........................................................................................ 208

Chapter 9 Leading: Theories and Models ............................................................ 215Theories and Models for Leading ........................................................ 217

Trait Theory and Skill Theory ........................................................ 217Behavior Theory ............................................................................ 218Situational Theory ......................................................................... 221Theory X, Theory Y, and Theory Z ................................................ 224Transactional and Transformational Leadership ............................. 225Servant Leadership ........................................................................ 227Collaborative Leadership ............................................................... 227Authentic Leadership and Ethical Leadership ................................ 229Leadership Competency Models .................................................... 229

Leading Physicians ............................................................................. 230

Chapter 10 Leading: Motivating and Influencing .................................................. 239Motivation Theory and Models .......................................................... 241

Maslow’s Hierarchy of Needs Theory ............................................. 242Alderfer’s ERG Theory ................................................................... 243Herzberg’s Two-Factor Theory ....................................................... 244McClelland’s Acquired Needs Theory ............................................ 247Adams’s Equity Theory .................................................................. 248Vroom’s Expectancy Theory ........................................................... 249Locke’s Goal-Setting Theory .......................................................... 251Skinner’s Reinforcement Theory .................................................... 252

Power and Politics .............................................................................. 255Sources and Types of Power ........................................................... 255Organization Politics ..................................................................... 257

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Chapter 11 Leading: Culture and Ethics ............................................................... 265What Is Culture? ................................................................................ 267

What Causes and Creates Culture? ................................................ 268Purpose and Benefits of Culture .................................................... 271Interpreting Culture ...................................................................... 271Subcultures .................................................................................... 273

Shaping and Managing Culture .......................................................... 273What Is Ethics? ................................................................................... 276

Ethics Problems ............................................................................. 276Sources of Ethics ........................................................................... 278Creating and Maintaining Ethics in an HCO ................................ 283

Chapter 12 Controlling and Improving Performance ............................................ 291What Is Control? ................................................................................ 293

Control in HCOs .......................................................................... 293A Three-Step Control Method ............................................................ 295

Step 1: Set Performance Standards ................................................. 295Step 2: Measure Actual Performance and Compare It to Standards 297Step 3: Improve Performance If It Does Not Meet Standards ......... 302

Quality Improvement Programs and Methodologies ........................... 307Six Sigma ....................................................................................... 307Lean Production ............................................................................ 308High Reliability ............................................................................. 309

Controlling People ............................................................................. 313

Chapter 13 Making Decisions and Solving Problems ............................................ 319Decision Making and Decisions ......................................................... 321

Who Makes Decisions? .................................................................. 322Methods for Making Nonprogrammed Decisions............................... 323

Rational Approach ......................................................................... 323Satisficing Approach ...................................................................... 326Intuition Approach ........................................................................ 327Incremental Approach ................................................................... 327Evidence-Based Approach .............................................................. 328Garbage Can Approach ................................................................. 329

Barriers to Effective Decision Making ................................................. 330Data for Decision Making .................................................................. 331Trends in Decision Making ................................................................ 333Resolving Conflict .............................................................................. 334

Causes of Conflict ......................................................................... 334

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Conflict Resolution Model ............................................................ 335Additional Suggestions for Managing Conflict .............................. 336

Chapter 14 Managing Change .............................................................................. 343Change in HCOs ............................................................................... 345Managing Organization Change ......................................................... 346

Small-Scale Change ....................................................................... 346Eight-Step Approach to Large-Scale Change .................................. 349

Resistance to Change .......................................................................... 352Why People Resist Change ............................................................ 353Organization Characteristics That May Impede Change ................ 354Healthcare Characteristics That May Impede Change .................... 355How People Resist Change ............................................................ 356Force Field Analysis ....................................................................... 356Overcoming Resistance to Change ................................................ 358

Organization Learning and Organization Development ..................... 361

Chapter 15 Professionalism and Communication ................................................. 369Professionalism ................................................................................... 371

Emotional Intelligence ................................................................... 373Cultural Competence .................................................................... 376

Communication ................................................................................. 378Types of Communication .............................................................. 378Directions of Communication ....................................................... 379Communication Process ................................................................ 382Tips for Effective Communication ................................................ 390

A Management Case Study: Partners HealthCare ..................................... 397

Integrative Case Studies ................................................................................... 413

Real-World Applied Integrative Projects ...................................................... 427

Your Management Toolbox ............................................................................... 429

Glossary ................................................................................................................. 433

Index ....................................................................................................................... 443

About the Author ................................................................................................ 473

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